Long-term gamma-aminobutyric acid (GABA) treatment fails to regain beta-cell function in longstanding type 1 diabetes in a randomized trial

Abstract Gamma-amino butyric acid (GABA) has in experimental studies been found to promote beta-cell proliferation, enhance insulin secretion and reduce inflammation, positioning it as a candidate drug for type 1 diabetes (T1D) therapy. This phase I/II randomized controlled trial assessed the safety...

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Main Authors: Henrik Hill, Per Lundkvist, Georgios Tsatsaris, Bryndis Birnir, Daniel Espes, Per-Ola Carlsson
Format: Article
Language:English
Published: Nature Portfolio 2025-04-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-95751-y
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author Henrik Hill
Per Lundkvist
Georgios Tsatsaris
Bryndis Birnir
Daniel Espes
Per-Ola Carlsson
author_facet Henrik Hill
Per Lundkvist
Georgios Tsatsaris
Bryndis Birnir
Daniel Espes
Per-Ola Carlsson
author_sort Henrik Hill
collection DOAJ
description Abstract Gamma-amino butyric acid (GABA) has in experimental studies been found to promote beta-cell proliferation, enhance insulin secretion and reduce inflammation, positioning it as a candidate drug for type 1 diabetes (T1D) therapy. This phase I/II randomized controlled trial assessed the safety and efficacy of long-term treatment with Remygen® (Diamyd Medical), a controlled-release oral GABA formulation, as a potential beta-cell regenerative therapy in adults with long-standing T1D. Thirty-five male subjects with T1D (≥ 5 years) were randomized into three arms receiving the study drug(s) once daily for 6 months: GABA 200 mg (Arm 1), GABA 600 mg (Arm 2) and GABA 600 mg + alprazolam 0.5 mg for 3 months followed by GABA 600 mg alone for 3 months (Arm 3). Safety measures, hormonal counter-regulation during hypoglycemic clamps, fasting- and stimulated C-peptide levels, were assessed at multiple timepoints. Safety concerns included elevated aspartate aminotransferase (AST) in nine subjects, leading to the withdrawal of two subjects. Most elevations were, however, transient with no dose-differences. No effects were observed on fasting- or stimulated C-peptide levels, CGM metrics or HbA1c. Hypoglycemic hormonal counter-regulation was unaltered. To conclude, we found no clinical evidence of a beta-cell regenerative effect of GABA, but side effects were commonly observed.
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spelling doaj-art-58a9e93c0d4448dc97e89b2386f7b33f2025-08-20T03:04:58ZengNature PortfolioScientific Reports2045-23222025-04-0115111210.1038/s41598-025-95751-yLong-term gamma-aminobutyric acid (GABA) treatment fails to regain beta-cell function in longstanding type 1 diabetes in a randomized trialHenrik Hill0Per Lundkvist1Georgios Tsatsaris2Bryndis Birnir3Daniel Espes4Per-Ola Carlsson5Department of Women’s and Children’s Health, Uppsala UniversityDepartment of Medical Sciences, Uppsala UniversityDepartment of Medical Sciences, Uppsala UniversityDepartment of Medical Cell Biology, Uppsala UniversityDepartment of Medical Sciences, Uppsala UniversityDepartment of Medical Sciences, Uppsala UniversityAbstract Gamma-amino butyric acid (GABA) has in experimental studies been found to promote beta-cell proliferation, enhance insulin secretion and reduce inflammation, positioning it as a candidate drug for type 1 diabetes (T1D) therapy. This phase I/II randomized controlled trial assessed the safety and efficacy of long-term treatment with Remygen® (Diamyd Medical), a controlled-release oral GABA formulation, as a potential beta-cell regenerative therapy in adults with long-standing T1D. Thirty-five male subjects with T1D (≥ 5 years) were randomized into three arms receiving the study drug(s) once daily for 6 months: GABA 200 mg (Arm 1), GABA 600 mg (Arm 2) and GABA 600 mg + alprazolam 0.5 mg for 3 months followed by GABA 600 mg alone for 3 months (Arm 3). Safety measures, hormonal counter-regulation during hypoglycemic clamps, fasting- and stimulated C-peptide levels, were assessed at multiple timepoints. Safety concerns included elevated aspartate aminotransferase (AST) in nine subjects, leading to the withdrawal of two subjects. Most elevations were, however, transient with no dose-differences. No effects were observed on fasting- or stimulated C-peptide levels, CGM metrics or HbA1c. Hypoglycemic hormonal counter-regulation was unaltered. To conclude, we found no clinical evidence of a beta-cell regenerative effect of GABA, but side effects were commonly observed.https://doi.org/10.1038/s41598-025-95751-yType 1 diabetesGABABeta-CellOral therapyRegenerative therapy
spellingShingle Henrik Hill
Per Lundkvist
Georgios Tsatsaris
Bryndis Birnir
Daniel Espes
Per-Ola Carlsson
Long-term gamma-aminobutyric acid (GABA) treatment fails to regain beta-cell function in longstanding type 1 diabetes in a randomized trial
Scientific Reports
Type 1 diabetes
GABA
Beta-Cell
Oral therapy
Regenerative therapy
title Long-term gamma-aminobutyric acid (GABA) treatment fails to regain beta-cell function in longstanding type 1 diabetes in a randomized trial
title_full Long-term gamma-aminobutyric acid (GABA) treatment fails to regain beta-cell function in longstanding type 1 diabetes in a randomized trial
title_fullStr Long-term gamma-aminobutyric acid (GABA) treatment fails to regain beta-cell function in longstanding type 1 diabetes in a randomized trial
title_full_unstemmed Long-term gamma-aminobutyric acid (GABA) treatment fails to regain beta-cell function in longstanding type 1 diabetes in a randomized trial
title_short Long-term gamma-aminobutyric acid (GABA) treatment fails to regain beta-cell function in longstanding type 1 diabetes in a randomized trial
title_sort long term gamma aminobutyric acid gaba treatment fails to regain beta cell function in longstanding type 1 diabetes in a randomized trial
topic Type 1 diabetes
GABA
Beta-Cell
Oral therapy
Regenerative therapy
url https://doi.org/10.1038/s41598-025-95751-y
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